Serum levels of cortisol in man during etomidate, fentanyl and air anesthesia, compared with neurolept anesthesia.

The effects of etomidate and fentanyl given as a mixture in continuous infusion and of a classical neuroleptanalgesia, with droperidol and fentanyl, on the serum cortisol levels were compared during and after anesthesia in sixteen patients who were to undergo major abdominal surgery. The results showed that the postoperative increase of serum cortisol levels which occurred in the neurolept group was absent in the group receiving etomidate and fentanyl infusion. During etomidate-fentanyl anesthesia there was a more significant decrease of serum cortisol and no rise in serum cortisol levels in response to synthetic ACTH injection. Etomidate and fentanyl, given as a continuous infusion during major abdominal surgery, block the adrenal mechanism to secrete endogenous cortisol in response to stress or after the administration of adreno-corticotrope hormone.